Active Rehabilitation After Childhood and Adolescent Mild Traumatic Brain Injury: a Narrative Review and Clinical Practice Implications

  • Jason A. Hugentobler
  • Catherine Quatman-Yates
  • Nathan K. Evanson
  • Andrea Paulson
  • Caitlin Chicoine
  • Barynia Backeljauw
  • Christina L. Santia
  • Brad G. KurowskiEmail author
Pediatric Rehabilitation Medicine (A Houtrow and M Fuentes, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Pediatric Rehabilitation Medicine


Purpose of Review

Development of rehabilitation strategies for youth after mTBI can be challenging for the rehabilitation professional. The purpose of this narrative review is to highlight current evidence for the use of active rehabilitation to manage common impairments after concussion/mild traumatic brain injury (mTBI).

Recent Findings

Exertional intolerance, vestibular deficiency, visual problems, and cervical dysfunction are common after mTBI. Active rehabilitation strategies targeting these problems are likely effective at reducing these impairments, leading to improved functioning.


Active rehabilitation recommendations for mTBI are evolving rapidly. There appears to be consensus that various impairment domains can be targeted with exercise and education after a thorough evaluation. More rigorous studies within the youth population are needed to move the field toward individualized, active rehabilitation strategies for youth after mTBI.


Concussion Youth Active rehabilitation Traumatic brain injury 



Mild traumatic brain injury


Randomized clinical trials


Vestibular/Ocular Motor Screening


Dynamic visual acuity


Motion sensitivity test


Dizziness Handicap Index


Vestibular therapy


Range of motion


Cervical range of motion


Compliance with Ethical Standards

Conflict of Interest

Brad Kurowski reports grants from NIH outside the submitted work. Jason Hugentobler, Catherine Quatman-Yates, Nathan Evanson, Andrea Paulson, Caitlin Chicoine, Barynia Backeljauw, and Christina L. Santia declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jason A. Hugentobler
    • 1
  • Catherine Quatman-Yates
    • 1
    • 2
  • Nathan K. Evanson
    • 3
    • 4
  • Andrea Paulson
    • 3
    • 4
  • Caitlin Chicoine
    • 3
  • Barynia Backeljauw
    • 3
  • Christina L. Santia
    • 3
  • Brad G. Kurowski
    • 3
    • 4
    Email author
  1. 1.Division of Occupational Therapy and Physical TherapyCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  2. 2.Department of Physical TherapyThe Ohio State UniversityColumbusUSA
  3. 3.Division of Physical Medicine and RehabilitationCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  4. 4.Departments of Pediatrics and Neurology and Rehabilitation MedicineUniversity of Cincinnati College of MedicineCincinnatiUSA

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